A multicentre comparison of transradial and transfemoral approaches for coronary angiography and PTCA in obese patients: the TROP registry

Aims: The incidence of obesity is increasing continuously in industrial countries. Vascular complications after the transfemeral approach (TF) for either coronary angiography (CA) or angloplasty (PCI) are more frequent ri this population. The transradial approach may decrease the risk of such complications. Methods and results: We undertook a prospective, multicentre, Europear registly of overweight patients (BMI ≥35), undergoing CA and/or PCI:n centres with broad experience in the transradial approach (TR). The vascular approach was left to the operator's discret on. The primary end point was the occurrence of access related complications resulting in delayed hospital discharge 555 patients, (age 60.8±10.9 years; males 57 3%: BMI: 38 5±3.6 kg/m 2 ) were included in the study. Of these, 157 underwen tne transfemoral approach and 398 the transradial. Total procedure time was significantly shorter for the transradial approach in these morbidly obese patients (TR: 35.5±25.8 min versus TF: 52.4±25.2min, p=0.0001), and hospital stay after CA or PCI was significantly snorter in the transracial group (I R: 8±2.3 days versus TF: 25±4.3 days, o=0.04). Vascular complications delaying hospital discharge occurred to 0.8% of TR patients vs 5.1 % TF patients. p=C.0009). Conclusions: The rate of vascular complications in overweight patients after CA or PCI can be significantly decreased by the use of the transradial approach in centres with a large experience.